Provider Demographics
NPI:1396412672
Name:YOUNG, COURTNEY E
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:E
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:7782 WINDWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-6343
Mailing Address - Country:US
Mailing Address - Phone:720-556-8706
Mailing Address - Fax:
Practice Address - Street 1:10246 PROGRESS LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4044
Practice Address - Country:US
Practice Address - Phone:720-515-8254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPSLP.0000864OtherSTATE OF COLORADO DORA (DEPT. OF REGULATORY AGENCIES)
MD14282399OtherASHA - CERT. OF CLINICAL COMPETENCE IN SLP